Biomedical subjects
Publications and source records attributed to R Kitagawa.
Explore the source record for details and available documents.
This is a case report of a pheochromocytoma which developed in a 67-year-old man. The patient presented himself with a productive cough and orthopnea, both of which were subsequently proved to be due to hypertensive heart failure. The diagnosis of a pheochromocytoma originating from the left adrenal gland was established endocrinologically and roentgenologically. Transperitoneal adrenalectomy was undertaken, and a tumor weighing 300 g was obtained. Histopathologically, the tumor was composed of two elements: cells with profuse cytoplasma having chromaffin-positive granules, and other cells consisting of spindle cells with mitosis. Surgical exploration could not identify another tumor or metastasis, and his blood pressure returned to normal, with normal catecholamine levels, after surgery. This is the first reported case of an elderly person with a pheochromocytoma complicated by congestive heart failure and renal insufficiency preoperatively; however, it was controlled well, and he underwent surgery successfully. This case constitutes the 64th report on a pheochromocytoma in persons over 60 years of age in the Japanese literature.
During intraperitoneal nephrectomy, the spleen may be injured inadvertently. Splenic salvage is mandatory in this situation; however, it requires some skill and extra time to control the bleeding. The authors present a very simple technique to replace the organ and retroperitonealize it in the nephrectomized fossa after some suture ligations have been placed in the major bleeding site.
The statistics of genitourinary tumors proved by histology as benign or malignant were analyzed for a total of 7,705 patients at the Mito Saiseikai Hospital from 1974 to 1984. The prostate, the bladder, and the kidney were the organs from which the tumors originated most frequently, in that order. Among the benign tumors, benign prostatic hyperplasia (55 cases) was the most frequent. Among the malignant tumors, bladder tumor (22 cases), prostate carcinoma (20 cases), and renal tumor (9 cases) were the most frequent. The overall 5-year survival rate was 50%. The survival of patients with bladder tumor was similar to that of the patients with renal pelvic or ureteral tumors of a transitional-cell origin. The worst survival was observed in penile carcinoma. It can be concluded that the incidence and survival of genitourinary tumors in the Mito area were not significantly different from those reported in other parts in Japan.
Explore the source record for details and available documents.
Ion chromatography was used to determine urinary oxalate concentration. The minimal detectable limit in a standard solution was 0.02 microgram/ml, and the regression line for the standard curve from 0.5 to 10 micrograms/ml had a significant correlation coefficient (p less than 0.01), but it was difficult to obtain reproducible results with ion chromatography. There were two obstacles: Urine was always oversaturated with calcium oxalate, and the presence of sulfate, the peak of which is next to the oxalate peak on the chromatogram of urine, seemed to interfere with oxalate conductivity. Comparison of 4 different dilutions of urine showed that the oxalate conductivity was highest in the 100-fold dilution and decreased gradually with increasing concentration. The conductivity of the oxalate standard (1 microgram/ml) also decreased as the concentration of sulfate increased. Therefore, it was concluded that to obtain reproducible results urine should be diluted 100-fold and that a recovery test by adding 0.25 microgram/ml oxalic acid should be performed on all urine samples.
This is a case report of an adrenal cyst which developed in a 36-year-old man. The patient experienced sudden abdominal pain, accompanied by sweating. The diagnosis was established by ultrasound-sonography and CT-scan. The adrenal cyst was removed surgically; it measured 20 X 10 X 10 cm and contained 1,900 ml of a white, cloudy fluid. Histological examination showed that the cyst wall was lined with mesothelial cells and was of congenital origin. The cyst was endocrinologically non-functioning, for all the endocrinological data were within normal limits. After surgery, however, hypertension has persisted and has been diagnosed as being essential in origin. This is the 63rd case reported in the Japanese literature.
The radioenzymatic method was used to determine the oxalate contents in common Japanese foods. High concentrations of oxalate were detected in spinach, Perilla frutescens, pepper, sesame, chocolate, and tea. Beer and coffee also contained some oxalate. Fruit and meat were low in oxalate content. Therefore, among the common Japanese foods, the most important foods to be avoided to restrict oxalate intake are chocolate, tea, and spinach.
Two cases of inverted papilloma, developed on the bladder neck in 36- and 23-year old males, are presented. From the Japanese literature, 40 cases of inverted papillomas have been collected and are reviewed. In addition, a review of the consecutive series of 173 pathological specimens, obtained by bladder biopsy and at the time of bladder surgery over the past 5 years disclosed a resembling lesion in two cases of bladder tumors. An inverted growth of transitional-cell carcinoma was observed in one case. Transitional-cell carcinoma with abundant microcysts was covered by the non-neoplastic transitional-cell epithelium in the other case. In conclusion, the inverted urothelial papilloma is more likely an inverted growth of the neoplastic epithelium with epithelial metaplasia and microcyst formation, much as is observed in so-called chronic proliferative cystitis, than a neoplastic transformation from chronic proliferative cystitis.
A 55-year-old male with penile epidermoid carcinoma of stage C (T3N3N0) underwent radical surgery. Emasculation with profuse skin removal, including the bilateral groins, and inguinal and pelvic lymphadenectomy were performed. A urethrostomy was created at the perineum, and the skin defect was covered with tensor fascia lata myocutaneous skin flaps. Immediately after recovery from surgery, 3 cycles of chemotherapy with cyclophosphamide, adriamycin and CDDP and radiation (5,000 rad) of the local area were given. The patient is now free from tumor recurrence 12 months after the surgery.
Long-term intra-arterial infusion chemotherapy with Adriamycin (ADM) was performed in cases of bladder cancer prior to total cystectomy. This report describes the effects in 13 cases evaluated more than 3 weeks after infusion of 10 mg ADM once or twice weekly. An oblique skin incision approximately 10 cm long was made in the gluteal region to expose the gluteus maximus muscle. A teflon catheter was then inserted into the gluteal artery and fixed; the distal end was brought out from under the skin in the precordial region. A similar procedure was performed on the contralateral side. The catheter was inserted through the superior and inferior gluteal arteries in five and eight cases, respectively. In the former group, partial response was obtained in two cases, minimal response in two and no response in one, so that primary tumor remission was evident in 40% of the cases. In the latter group, all cases but one attained partial response, i.e., remission was seen in 87.5% of cases treated by inferior gluteal infusion. Skin erosion of the gluteal, perineal, and anal regions and sciatica-like pain were observed in some cases; however neither myocardial effect nor bone marrow suppression, which have been reported as side-effects of ADM, were observed in any of the cases. These results suggest that this therapeutic modality could be effective in the preoperative work-up of candidates for total cystectomy, and also that it could be useful in the treatment of patients in whom total cystectomy is contraindicated.
This is a case report of a sarcomatous Wilms tumor complicating disseminated intravascular coagulation with gastrointestinal bleeding, ascites, pleural effusion, and hepatitis after the second course of actinomycin D. A sarcomatous Wilms tumor is believed to have an unfavorable prognosis even if multimodal therapy is given. Arteriovenous fistulae which we created for purposes of chemotherapy and hyperalimentation by microvascular-sleeve anastomosis functioned well for three years in spite of repeated punctures.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.